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Job Description:

OVERVIEW OF POSITION:

The Population Health Specialist supports Colorado Community Health Alliance (CCHA)’s Medicaid members by driving performance on the state's Medicaid quality metrics. This role works closely with clinical operations team, CCHA leadership, and health plan teams to identify care gaps, conduct quality audits,  coordinate outreach, and support data-driven interventions that improve outcomes for Colorado Medicaid members. The Population Health Specialist plays a central role in ensuring CCHA meets or exceeds Health First Colorado quality benchmarks and value-based contract requirements. The position supports Alpine's commitment to improving health outcomes for Colorado's Medicaid members through data-informed quality improvement and population health strategy.

Colorado residency is required for this position

ESSENTIAL DUTIES:

• Conducts clinical quality audits by collecting and organizing data to identify areas for quality improvement
• Performs attestations to improve quality metrics
• Performs outreach to external partners
• Provide valuable information to external facing partners in support of improving clinical quality measures and patient care through various reports used in educational forums
• Identify care gaps at the member and population level and coordinate outreach strategies to close gaps in preventive care, chronic disease management, and behavioral health screening.
• Identifies and communicates potential obstacles and errors and develops action plans to overcome those obstacles
• Identifies improvement opportunities and communicates ideas to others
• Provides support with audit appeals research
• Responds to practice inquiries in a timely and accurate manner
• Supports annual HEDIS medical record review and data collection processes as needed.
• Stays current on Colorado Medicaid policy changes, quality program updates, and RAE contract amendments that affect quality performance.

• Participate in special projects and perform other duties as assigned.
• Maintains confidentiality and ensures compliance with HIPAA regulations
• Other duties as assigned

EDUCATION:

High School Diploma/GED; associate or bachelor’s degree preferred.

EXPERIENCE:

•    1-3 years’ experience as a Medical Assistant, Medical Records Technician, or Referral Coordinator

•    1-3 years’ experience working with medical records and/or patients in a healthcare setting
 

Preferred experience:

• Experience working directly with a Colorado RAE or Medicaid managed care organization.
• Experience with care gap closure programs and member outreach strategy.

KNOWLEDGE, SKILLS, ABILITIES:

• Proficiency in Microsoft 365 office suite, including Outlook, Excel, PowerPoint, Word, Teams and SharePoint
• Knowledge of Electronic Medical Record systems
• Knowledge of diagnosis codes, CPT codes, and medical terminology
• Ability to learn and use new software and data tools
• Great customer service skills
• Self-motivated and self-managed
• Written and verbal communication skills.
• Proven project coordination skills.
• Ability to prioritize, self-direct, and perform detailed tasks with minimal supervision.
• Ability to manage multiple priorities and deadlines effectively
• Ability to establish and maintain effective working relationships with others
• Home office, that is HIPAA compliant for all remote or hybrid work arrangement positions as outlined by the company policies and procedures

Salary Range:

$19.71+